A reduced value on preoperative Onodera’s Prognostic Nutritional Index (OPNI) may indicate a poor postoperative prognosis for patients with gastrointestinal stromal tumor (GIST), according to a meta-analysis published in the Journal of Gastrointestinal Cancer.

The aggregate hazard ratio (HR) of recurrence-free survival (RFS) based on univariate analysis across 6 articles and encompassing 1910 patients with GIST was significantly higher for patients with lower preoperative OPNI (2.73; P <.00001). Multivariate analysis across 7 studies, which involved 2105 patients, also showed an increased risk of RFS with an HR of 1.82 (P <.00001).

“Our results confirmed the prognostic role of OPNI in postoperative gastrointestinal stromal tumors. This index is easy to obtain, lower cost, and is worthy of becoming a practical tool in clinical practice,” the authors said.

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This meta-analysis involved 8 studies with 2462 patients with GIST who underwent resection surgery. All studies were conducted in China, and 4 included adjuvant therapy. Mean age was 60 years.

No heterogeneity was observed between the univariate analysis (I2 =0), but a slight heterogeneity was observed in the multivariate analysis (I2 =39). Analysis of the publication bias risk (P =.904) and sensitivity analysis found that the multivariate analysis results were still reliable despite the heterogeneity (P >.05).

The OPNI can give a picture of a patient’s immune and inflammatory responses by analyzing levels of albumin and lymphocytes.

“It will take more prognostic studies, and studies started deliberately to validate OPNI in GIST patients before it can be definitively assessed as a risk factor for relapse,” the authors wrote.


Ren W, Wang H, Xiang T, Liu G. Prognostic role of preoperative Onodera’s prognostic nutritional index (OPNI) in gastrointestinal stromal tumors: a systematic review and meta-analysis. J Gastrointest Cancer. Published online November 8, 2022. doi:10.1007/s12029-022-00878-0